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Voice: 202-687-4949, Fax: 202-687-1162 Email: netidservices@georgetown.edu, http://uis.georgetown.edu/ Account Termination Form for Main Campus/GUMC EmployeesComplete this form at least five (5) days before the employees last day in the office and fax it to the Help Desk at 202-687-1162. The process may require the Help Desk to get in contact with the department with follow up questions or other issues. Information regarding departing employee Name __________________________________________ NetID __________________ Job title ________________________________________________________________ Date of last workday in the office _____________________________________________ Accounts the employee owned (please check all that apply) _____ NetID password _____ GUMail account (includes deleting mail in the account) _____ @georgetown.edu routing _____ Banner _____ Cognos _____ Genesys , include username _________ _____ SIS, include username ________ _____ PeopleSoft Financials _____ PeopleSoft Admissions _____ VPN _____ Web Account (for updating UIS-hosted sites) _____ Admin NetIDs/Aliases owned by departing employee, please list) _________________ Departmental contact in case of questions _____________________________________(please include name AND phone number) Department Head __________________________________________________ Department Head Signature ______________________________ Date _____________ |